A prospective study of the impact of chemotherapy-related toxicities on the quality of life in elderly patients with cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23013-e23013
Author(s):  
Sanketh Kotne ◽  
Bharadwaj Ponnada ◽  
Arun Philip ◽  
Pavithran Keechilat
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Mental Status ◽  
Comprehensive Geriatric Assessment ◽  
The Elderly ◽  
Assessment Tools ◽  
Elderly Cancer Patients

e23013 Background: Treatment of cancer in elderly is challenging. Majority of the elderly cancer patients are offered chemotherapy based on their performance scale and geriatric assessment tools are not routinely employed in clinical practice as they are time consuming and cumbersome. Aim: The primary objective was to estimate the incidence of chemotherapy related adverse events in newly diagnosed elderly cancer patients above 65 years of age treated at a tertiary cancer institute in southern India. The secondary objective was to predict and assess the factors associated with chemotherapy related toxicities in the elderly patients using the Cancer and Aging Research Group's (CARG) scoring tool and to study the quality of life and to assess the nutritional status and the mental status in elderly cancer patients above 65 years of age. Methods: A prospective cross-sectional study was done among 179 patients with age ≥ 65 years, a solid organ cancer (any type or stage) from February 2017 to August 2018. Prechemotherapy comprehensive geriatric assessment (CGA) with Older People’s Quality of Life Questionnaire (OPQOL-35), Mini Nutritional assessment (MNA) and Folstein’s Mini Mental status examination (MMSE) was done at baseline, 2 months and 6 months. CARG tool was used to predict the risk of chemotherapy toxicity with the standard and modified dose. Results: The mean age was 68.53 years. Majority of the patients had breast cancer 29.60%. The proportion of lung cancer, prostate cancer, stomach cancer, colorectal and ovarian cancers were 21.80%,10.60%, 9.50%, 14.5% and 7.30% respectively. Other cancers were seen in 5 patients (2.79%). 40 (22.30%) patients had received anthracycline based chemotherapy. 143 (79.90%) had received standard dosing chemotherapy.118 (65.90%) & 125 (69.80%) out of 179 patients had developed hematological toxicities and non- hematological toxicities respectively. According to the ROC curve for the CARG tool risk of toxicity with standard & modified dosing and hematological & non- hematological toxicities, the accuracy of the test is 60.89% indicating its poor predictive validity. There is a decline in the CGA at 2 months follow-up, but there was an improvement after assessment at 6 months. Conclusions: Comprehensive geriatric assessment at base line is required to adequately analyse patient’s risk of chemotherapy related toxicities. In our study, the patients have tolerated the chemotherapy well in spite of receiving standard dosing.

scholarly journals Nutrition in Cancer Therapy in the Elderly—An Epigenetic Connection?

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3366
Author(s):  
Janusz Blasiak ◽  
Jan Chojnacki ◽  
Elzbieta Pawlowska ◽  
Joanna Szczepanska ◽  
Cezary Chojnacki
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Cancer Therapy ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
The Elderly ◽  
Assessment Tools ◽  
Continuous Increase ◽  
Epigenetic Profile

The continuous increase in life expectancy results in a steady increase of cancer risk, which consequently increases the population of older adults with cancer. Older adults have their age-related nutritional needs and often suffer from comorbidities that may affect cancer therapy. They frequently are malnourished and present advanced-stage cancer. Therefore, this group of patients requires a special multidisciplinary approach to optimize their therapy and increase quality of life impaired by aging, cancer, and the side effects of therapy. Evaluation strategies, taking advantage of comprehensive geriatric assessment tools, including the comprehensive geriatric assessment (CGA), can help individualize treatment. As epigenetics, an emerging element of the regulation of gene expression, is involved in both aging and cancer and the epigenetic profile can be modulated by the diet, it seems to be a candidate to assist with planning a nutritional intervention in elderly populations with cancer. In this review, we present problems associated with the diet and nutrition in the elderly undergoing active cancer therapy and provide some information on epigenetic aspects of aging and cancer transformation. Nutritional interventions modulating the epigenetic profile, including caloric restriction and basal diet with modifications (elimination diet, supplementary diet) are discussed as the ways to improve the efficacy of cancer therapy and maintain the quality of life of older adults with cancer.

scholarly journals Correlation between comorbidity and quality of life in the elderly cancer patients treated with chemotherapy: An ongoing study

2002 ◽  
Vol 10 (3) ◽  
pp. 146-146
Author(s):  
Svetlana Jezdic ◽  
Zorica Nikolic-Tomasevic ◽  
Ivan Popov ◽  
Davorin Radosavljevic
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
The Elderly ◽  
Ongoing Study ◽  
Elderly Cancer Patients

scholarly journals Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older?

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 635
Author(s):  
Aurore Goineau ◽  
Loïc Campion ◽  
Jean-Marie Commer ◽  
Brigitte Vié ◽  
Agnès Ghesquière ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
The Elderly ◽  
Localized Prostate Cancer ◽  
Curative Intent ◽  
Moderate Reduction ◽  
Curative Radiotherapy

Curative radiotherapy for prostate cancer is common in the elderly. However, concerns about potential toxicity have inhibited access to radiotherapy for this population, for whom preserving quality of life (QoL) is crucial. The primary endpoint was to identify predictors of impaired QoL in men aged 75 years or older treated with curative intent radiotherapy with or without androgen deprivation therapy (ADT) for localized prostate cancer. We prospectively performed comprehensive geriatric assessment (CGA) and administered QoL questionnaires to 208 elderly (>75 years) patients prior to, plus two and six months after, radiotherapy (NCT 02876237). The median age of the patients was 77 years (range 75–89). At the start of the study, comorbidities were highlighted in 65% of patients: 23% were depressed, 23% had cognitive impairment, and 16% had reduced independence. At six months, 9% of patients had a consistently decreased QoL (>20 points), and a further 16% had a more moderate reduction (10 to 20 points) in QoL. None of the parameters studied (tumor characteristic, treatment, or oncogeriatric parameters) were predictive of a reduced QoL following radiotherapy. Though co-existing geriatric impairment was common, QoL was maintained for 75% of patients six months after radiotherapy. CGA was poorly predictive of tolerance of prostatic radiotherapy. Geriatric assessments dedicated to quality of life following radiotherapy need to be developed.

scholarly journals A randomized clinical study on the impact of Comprehensive Geriatric Assessment (CGA) based interventions on the quality of life of elderly, frail, onco-hematologic patients candidate to anticancer therapy: protocol of the ONCO-Aging study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdurraouf Mokhtar Mahmoud ◽  
Federica Biello ◽  
Paola Maria Maggiora ◽  
Riccardo Bruna ◽  
Giovanni Burrafato ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Geriatric Assessment ◽  
Frail Elderly ◽  
Comprehensive Geriatric Assessment ◽  
Fine Tuning ◽  
Biological Study ◽  
Plasma Samples ◽  
The Impact

Abstract Background Age is considered as one of the most important risk-factor for many types of solid and hematological cancers, as their incidence increases with age in parallel to the ever-growing elderly population. Moreover, cancer incidence is constantly increasing as a consequence of the increase in life expectancy that favors the process of cellular senescence. Geriatric assessment has been increasingly recognized as predictive and prognostic instrument to detect frailty in older adults with cancer. In particular, the G8 score is a simple and reproducible instrument to identify elderly patients who should undergo full geriatric evaluation. Due to their frailty, elderly patients may be often under-treated and a therapeutic choice based also on a comprehensive geriatric assessment (CGA) is recommended. With these premises, we aim to test the impact of the CGA based interventions on the quality of life (QoL) of frail elderly onco-hematological patients, identified by the G8 screening, candidate for innovative target directed drugs or treatments including the combination of radiotherapy and chemotherapy (RT + CT). Methods Patients aged > 65 years, candidate to target directed agents or to RT + CT treatments are screened for frailty by the G8 test; those patients classified as frail (G8 ≤ 14) are randomized to receive a CGA at baseline or to conventional care. The primary endpoint is QoL, assessed by EORTC QLQ-C30C. As collateral biological study, the potential prognostic/predictive role of T-cell senescence and myeloid derived suppressor cells (MDSC) are evaluated on plasma samples. Discussion This trial will contribute to define the impact of CGA on the management of frail elderly onco-hematologic patients candidate to innovative biological drugs or to integrated schedules with the association of RT + CT. Furthermore, the use of plasma samples to assess the potential prognostic value of imbalance of immune-competent cells is expected to contribute to the individualized care of elderly patients, resulting into a fine tuning of the therapeutic strategies. Trial registration ClinicalTrials.gov ID: NCT04478916. registered July 21, 2020 – retrospectively registered.

scholarly journals Comprehensive Geriatric Assessment and quality of life after localized prostate cancer radiotherapy in elderly patients

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0194173 ◽  
Author(s):  
Aurore Goineau ◽  
Loïc Campion ◽  
Bénédicte d’Aillières ◽  
Brigitte Vié ◽  
Agnès Ghesquière ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Elderly Patients ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Localized Prostate Cancer ◽  
Cancer Radiotherapy ◽  
Prostate Cancer Radiotherapy

scholarly journals Glioblastoma: approach to treat elderly patients

2012 ◽  
Vol 10 (4) ◽  
pp. 512-518 ◽  
Author(s):  
Luciola de Barros Pontes ◽  
Theodora Karnakis ◽  
Suzana Maria Fleury Malheiros ◽  
Eduardo Weltman ◽  
Reynaldo André Brandt ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Local Control ◽  
Comprehensive Geriatric Assessment ◽  
Performance Status ◽  
Tumor Resection ◽  
Total Resection ◽  
Elderly Cancer Patients ◽  
Therapeutic Modalities

Treating elderly cancer patients is a challenge for oncologists, especially considering the several therapeutic modalities in glioblastoma. Extensive tumor resection offers the best chance of local control. Adequate radiotherapy should always be given to elderly patients if they have undergone gross total resection and have maintained a good performance status. Rather than being ruled out, chemotherapy should be considered, and temozolomide is the chosen drug. A comprehensive geriatric assessment is a valuable tool to help guiding treatment decisions in elderly patients with glioblastoma.

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